Are Two Annual Dental Visits One Too Many – or Not Enough?

For decades, conventional wisdom held that certain dental procedures were best practices and were right for all people. You brushed your teeth after every meal (or at least morning and night) flossed daily, and visited the dentist twice a year. At each visit, you got an exam, X-rays and a cleaning. If you were a child, you could add on a fluoride treatment and perhaps sealants on your molar teeth.

However, thanks to advances in molecular medicine, genetics and other areas of research, health care in general (including oral health care) is being transformed from a system of treating disease in a one-size-fits-all manner to one that provides predictive, proactive, preventive and personalized care. Oral health care advances also allows for a more customized and tailored approach to each person’s individual situation.

Sure, basic prevention activities like brushing with fluoride toothpaste, flossing and drinking fluoridated water regularly is important for all. Based on risk factors, however, some people are considered at higher risk and some at lower risk for developing oral diseases like tooth decay, periodontal (gum) disease or oral cancer. Your risk for disease may help you determine what level of more costly professional services may be most beneficial. People with a history of good oral health, good dietary and oral hygiene habits, and no genetic red flags may need to only visit the dentist once a year or less. Conversely, those with a history of disease and other risk factors may need two or more routine visits each year.

A recent study published in the Journal of Dental Research looked at individual’s risk for periodontal disease and concluded that for low-risk individuals, “the association between preventive dental visits (dental cleaning) and tooth loss was not significantly different whether the frequency was once or twice annually.”1 It went on to recommend evaluating genetic tendencies for gum disease with conventional risk factors (smoking and diabetes) when assessing how often a patient needs to visit the dentist.1 While this study looked specifically at gum disease risk, risk factors are also established for other oral problems such as tooth decay and oral cancer.

In response to the JDR study, the American Dental Association released a statement to “remind consumers that the frequency of their regular dental visits should be tailored by their dentists to accommodate for their current oral health status and health history.” 2

For those who are unaware of their personal risk factors, Delta Dental provides an online tool (myDentalScore) that can help you self-assess your level of risk for gum disease, tooth decay and oral cancer. This self-assessment will provide you with valuable information to help you have a good discussion with your dentist about the best mix of self-care and professional care for you as an individual.

Ultimately, Delta Dental encourages consumers to honestly evaluate themselves and seek the kind of dental care that will be most beneficial to their oral health.

Patient Stratification for Preventive Care in Dentistry.  http://jdr.sagepub.com/content/early/2013/06/05/0022034513492336.abstract

2 American Dental Association. American Dental Association Statement on Dental Visits.  http://www.ada.org/8700.aspx

How to Handle Tooth Trauma

As children head back to school, it is important to remember that dental emergencies can happen any time, any place. According to the 2013 Delta Dental Children’s Oral Health Survey,1 one out of 10 children ages 10 or 11 have had a tooth emergency such as a knocked-out tooth, chipped tooth or a loosened permanent tooth at home or at school.

A knocked-out permanent tooth is a true dental emergency, and there’s a good chance it can be saved if you know what to do and act quickly. The primary concern should be getting the child in to see a dentist. Time is crucial if you want the dentist to be able to reinsert and salvage the natural tooth. Ideally, a child needs to be seen within 30 minutes of the accident.1

Whether a tooth is knocked out at school or home, here are several steps to ensure it is saved – or at least in optimal condition – by the time the child can see the dentist.

  • First, check to make sure the child doesn’t have a serious head, neck or other orofacial injury (i.e., a concussion, broken jaw, etc.).
  • Don’t worry about replacing a displaced baby tooth. Trying to reinsert it could damage the permanent pearly white coming in behind it.
  • To avoid infection, the tooth should be held by the crown, not the root. The crown is the part of the tooth visible to the naked eye. You want to leave the root intact, and touching it with bare hands could pass bacteria.2
  • Rinse any debris off of the tooth under room temperature water. Don’t scrub the root! Once the tooth is free of loose dirt and debris, try to reinsert it, asking the child to hold it in place using a piece of gauze if necessary. 3
  • If the tooth cannot be successfully reinserted, it needs to stay moist until the child can visit a dentist. Store the tooth in a clean container and cover it with milk or room temperature water to prevent it from drying out. 4 These liquids aren’t ideal but are often the only ones readily available. If you are a school nurse or your child frequently plays contact sports, purchase an emergency bag  handy with a save-a-tooth kit in it (available at most drugstores.) These contain a solution that is better at preserving any live cells on the tooth root until the dentist can put the tooth back into the socket.

In most cases, tooth injuries are not life threatening. But they can have long-lasting effects on the child’s appearance and self-confidence, so it is important to act quickly in the event of a dental emergency.

1Morpace Inc. conducted the 2013 Delta Dental Children’s Oral Health Survey. Interviews were conducted nationally via the Internet with 926 primary caregivers of children from birth to age 11. For results based on the total sample of national adults, the margin error is ±3.2 percentage points at a 95 percent confidence level.

2“Saving a Knocked-Out Tooth.” American Association of Endodontists. http://www.aae.org/patients/patientinfo/references/avulsed.htm. Accessed 2010.

3 “Medical Encyclopedia: Broken or Knocked Out Tooth.” U.S. National Library of Medicine and the National Institutes of Health, February 22, 2010. www.nlm.nih.gov/medlineplus/ency/article/000058.htm. Accessed 2010.

4“Dental Emergencies.” American Dental Association. http://www.ada.org/370.aspx Accessed 2010.